After the feasibility to reform the blended teaching model for health information management and its im-plementation were described , the reform of blended teaching model for health information management and its prob-lems were analyzed in terms of its model establishment , process implementation and effect assessment according to the target of professional training in Bengbu Medical College .

Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

OBJECTIVETo explore CBFbeta/MYH11 fusion transcripts and its expressing product CBFbeta/SMHHC fusion protein in mechanism of leukemogenesis.

METHODSCBFbeta/MYH11 fusion transcripts were detected by combined RT-PCR with sequencing. Transcription assays were examined using pM-CSFR-Luc as reporting plasmid, and subcellular localization of encoding proteins were assayed by double immunofluorescent staining and Western blot.

RESULTSTwo types of CBFbeta/MYH11 fusion transcripts were found in 26 patients with acute leukemia, most being of type A (23/26 cases, 92%) and a few of type D (2/26 cases, 8%). The inhibition of CBF-mediated M-CSFR promotor transactivation by CBFbeta/SMHHC fusion protein was increasing with the increase in amount of the fusion protein. CBFalpha subunit (AML1) located in nucleus, both CBFbeta subunit (CBFbeta) and CBFbeta/SMHHC located in cytoplasm. When AML1 and CBFbeta were coexpressed, CBFbeta still located mainly in cytoplasm, but when AML1 and CBFbeta/SMHHC were coexpressed, CBFbeta/SMHHC located mainly in nucleus.

CONCLUSIONS(1) The types of CBFbeta/MYH11 fusion transcripts of Chinese leukemia patients are almost the same as that reported in western literature. (2) CBFbeta/SMHHC inhibits CBF-mediated transactivation through competing with CBFbeta for binding to AML1.

Adult ; Female ; Humans ; Leukemia, Myelomonocytic, Acute ; genetics ; metabolism ; Male ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Transcription, Genetic

The aim of this study was to investigate the effects of agmatine (Agm) on the electrical activity of neurons in subfornical organ (SFO) slices using extracellular recording technique. The results are as follows. (1) In response to the application of Agm (1.0 micromol/L) into the superfusate for 2 min, the discharge rate of 24/28 (85.7%) subfornical neurons was decreased significantly, while the discharge rate of 4/28 (14.3%) neurons were not affected. (2) Pretreatment with L-glutamate (0.3 mmol/L) led to a marked increase in the discharge rate of 19/24 (79.2%) subfornical neurons in an epileptiform pattern and the activity of the remaining 5/24 (20.8%) neurons was unaffected. By application of Agm (1.0 micromol/L) into the superfusate for 2 min, the epileptiform dicharge of 15/19 (78.9%) neurons was suppressed significantly, while that of the other 4 (21.1%) neurons was not inhibited. (3) In 12 neurons, perfusion of the selective L-type calcium channel agonist, Bay K-8644 (0.1 micromol/L), induced a significant increase in the discharge rate of 10/12 (83.3%) neurons, while the other 2 (16.7%) neurons showed no change. The increased discharge of 8/10 (80%) neurons was reduced by application of Agm (1.0 micromol/L) into the superfusate and that of 2/10 (20%) neurons was not affected. (4) Application of nitric oxide synthase (NOS) inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME, 50 micromol/L) into the superfusate also significantly increased the discharge rate of 6/9 (66.7%) neurons, and that of 3/9 (33.3%) neurons had no response. Agm (1.0 micromol/L) applied into the superfusate reduced the increased discharge of all 6/6 (100%) neurons. These results suggest that Agm can inhibit the spontaneous discharge, and L-glutamate, Bay K-8644- or L-NAME-induced discharge of neurons in SFO. These inhibitory effects of Agm may be related to the blockade of NMDA receptors and reduction in calcium influx in SFO neurons.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; pharmacology ; Action Potentials ; drug effects ; Agmatine ; pharmacology ; Animals ; Calcium Channel Agonists ; pharmacology ; Female ; Glutamic Acid ; pharmacology ; Hippocampus ; physiology ; Male ; Neurons ; physiology ; Rats ; Rats, Sprague-Dawley ; Receptors, Drug ; agonists ; Receptors, N-Methyl-D-Aspartate ; antagonists & inhibitors ; Subfornical Organ ; drug effects ; physiology

Objective To investigate the added diagnostic value of SPECT/CT imaging over routine planar whole-body bone scintigraphy (WBBS) for bone metastases from lung cancer. Methods One hundred and forty-six patients with lung cancer, confirmed by pathological examination, underwent routine 99Tcm-MDP (1110 MBq) WBBS, followed by SPECT/CT over the regions with indeterminate findings on WBBS. Both WBBS and bone SPECT/CT images were interpreted by two experienced nuclear medicine physicians in consensus as the positive, negative or uncertain bone metastases. The final diagnosis was comfirmed by pathology or clinical follow-up. x2 test was used to compare the differences between the two imaging methods. Results Finally, 45 patients were diagnosed as positive bone metastases and the other 101 as negative. The diagnostic sensitivity of bone SPECT/CT for bone metastases from lung cancer was 93.3%(42/45), singnificantly higher than that of WBBS (64.4%, 29/45) (x2 = 19.944, P＜0.05). The diagnostic accuracy of bone SPECT/CT was 89.7% ( 131/146), much higher than that of WBBS (44.5%,65/146) ( x2 = 69. 598,P ＜ 0.05). The uncertain and incorrect diagnostic rates of bone SPECT/CT and WBBS were 10.3% ( 15/146, raging from 5.3% to 15.2% with 95% confidence interval (CI) ) and 55.5% (81/146, raging from 47. 4% to 63.5% with95% CI), respectively. Conclusion BoneSPECT/CT provides incremental diagnostic value over routine WBBS for bone metastases from lung cancer.

Objective To investigate the additional diagnostic value of 99Tcm-MDP SPECT/CT over conventional SPECT scan in patients with spinal bone malignancy. Methods Fifty-two patients (mean age (56±14) years) with suspicious spinal bone diseases underwent both bone SPECT and SPECT/CT imaging right after 99Tcm-MDP whole-body planar bone scintigraphy. All patients were pathologically diagnosed by either spine operation or trans-spinal biopsy. The images were evaluated by two independent reviewers; inter-reviewer agreement was evaluated using a weighted Kappa score. Each focus of abnormality was recorded using a 4-point diagnostic confidence scale: benign (B), possibly benign (PB), possibly malignant (PM) or malignant (M). Results Accord to the pathological results, 36 patients had bone malignancy (19 with metastatic tumors and 17 with non-metastatic tumors) and 16 had benign lesions. Over SPECT images, two reviewers rated 73.1% (38/52) and 67.3% (35/52) the lesions as the equivocal (PB or PM) respectively. Over SPECT/CT images, they rated only 25.0% (13/52) and 13.5% (7/52) lesions as the equivocal. Inter-reviewer agreement was 63.5% (weighted Kappa score=0.62) for SPECT and 78.9% (weighted Kappa score=0.81) for SPECT/CT. Conclusions Compared with99Tcm-MDP SPECT, 99Tcm-MDP SPECT/CT results in a significant reduction of equivocal diagnoses for the spinal bone malignancy.

The precondition of accurate gastric cancer surgery is precise assessment of lymph node metastasis. To date, no imaging modality achieves both high sensitivity and high specificity in detecting lymph node metastasis in gastric cancer. Intraoperative sentinel node tracing and biopsy are the most popular method to identify the localization of tumor cell, but is limited to early gastric cancer. Nano-composite materials, designed for tumor imaging and tracing, show us a newly emerging domain for tumor detection in gastric cancer. The function of these nano-composite materials to detect lymph node metastasis in gastric cancer relies on the effective backflow of lymph system. However, the lymph vessels can be obstructed by tumor cells in advanced gastric cancer, which may restrain the application of these nanoparticles. Therefore, more methods to detect lymph node metastasis in gastric cancer should be explored. This review summarizes the characteristic of the targeted nanosphere. Based on the reported studies, a novel idea is conceived that targeted multifunctional nanosphere may be a potential method to achieve precise assessment of lymph node metastasis in gastric cancer.
Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Stomach Neoplasms ; pathology

OBJECTIVETo discuss the diagnostic value of cardiac enzyme and troponin in acute organophosphorus pesticide poisoning (AOPP).

METHODSA retrospective study was performed in the document published in domestic journals and PubMed from 1979 to 2010. The data of the cardiac enzyme and troponin were collected. Statistical analysis was conducted with one-way ANOVA and rank sum test. 2129 cases with AOPP were enrolled.

RESULTSThe levels of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) in milder, moderate and severe poisoning groups were significantly elevated compared by the healthy control group (P < 0.05). The differences were also dramatic among three patients groups (P < 0.05). The ratios of CK-MB to CK in both moderate and severe groups were significantly lower than in healthy controls (P < 0.05). The levels of CK, CK-MB and cTnI were higher especially in patients with intermediate myasthenic syndrome (IMS) than patients without IMS. Meanwhile, the levels of CK and CK-MB were elevated in patients with respiratory failure compared by non-failure ones, but decreased in the ratios of CK-MB to CK (P < 0.05).

CONCLUSIONSThe elevation of CK and CK-MB in serum could not be judged as the criteria of myocardial damage in AOPP, the ratio of CK-MB to CK were more valuable; the value of cTnI in myocardial damage was still in suspect. CK, CK-MB and cTnI could be used as auxiliary criteria of AOPP classification.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiomyopathies ; diagnosis ; etiology ; Child ; Child, Preschool ; Creatine Kinase ; blood ; Creatine Kinase, MB Form ; blood ; Female ; Humans ; Infant ; Male ; Middle Aged ; Myocardium ; enzymology ; metabolism ; pathology ; Organophosphate Poisoning ; metabolism ; Troponin I ; blood ; Troponin T ; blood ; Young Adult

OBJECTIVETo discuss the effectiveness of severe and acute organophosphate poisoning (AOPP) treated with plasma exchange in China.

METHODSResearches about effectiveness of severe AOPP treated with plasma exchange were analyzed by Review Manager 4.2 and fixed effect model of meta-analysis method were used.

RESULTSSix trials including 433 patients were identified. Treatment group including 211 patients adopted traditional physician therapy plus plasma exchange, and control group including 222 patients received physician therapy only. The case-fatality rate of the treatment group was lower than the control one [RR=0.30, 95%CI (0.19-0.49), P<0.01].

CONCLUSIONPlasma exchange can improve the cure rate of severe AOPP.

Humans ; Organophosphate Poisoning ; therapy ; Pesticides ; poisoning ; Plasmapheresis

OBJECTIVETo study the relationships of hypoxia-induced factor (HIF) with tumor angiogenesis and early liver metastasis in colonic cancer.

METHODSThirty three cases of colon cancer undergoing radical surgery were divided into two groups according to liver metastasis or not within half a year after operation. Expressions of HIF and vascular endothelial growth factor (VEGF) were examined using immunohistochemical method and tumor microvessel density (MVD) was measured in colonic cancer specimens.

RESULTSFifteen cases developed early liver metastasis, while 18 did not. The positive rates of HIF and VEGF, and MVD were 86.7%, 66.7%, (57.9+/- 12.7)% respectively in the group with early liver metastasis, significantly higher than 44.4% (P< 0.05), 27.8% (P< 0.05) and (22.3+/- 10.2)% (P< 0.01) respectively in the group without early liver metastasis respectively.

CONCLUSIONHIF can promote tumor angiogenesis in colonic cancer, and is closely related with early liver metastasis.

Adult ; Aged ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Hypoxia-Inducible Factor 1 ; metabolism ; Liver Neoplasms ; blood supply ; secondary ; Male ; Microvessels ; Middle Aged ; Neovascularization, Pathologic ; Vascular Endothelial Growth Factor A ; metabolism